Attachable clamp for use with surgical instruments

ABSTRACT

An attachable clamp for use with a surgical instrument is disclosed. The attachable clamp comprises a body portion, a first jaw member, a second jaw member and an actuation mechanism. The body portion defines a longitudinal axis and has attachment members configured to attach to an elongate portion of a surgical instrument. Each of the first jaw member and second jaw member extends distally from the body portion. The actuation mechanism is disposed in mechanical cooperation with at least one of the first jaw member and the second jaw member. Actuation of the actuation mechanism moves at least one of the first and second jaw members between an approximated position and an open position with respect to the other jaw member.

CROSS-REFERENCE TO RELATED APPLICATIONS

This is a continuation of U.S. patent application Ser. No. 13/956,887,filed Aug. 1, 2013, which claims priority to, and the benefit of, U.S.patent application Ser. No. 12/467,324, filed on May 18, 2009, now U.S.Pat. No. 9,023,069, the entire contents of which are hereby incorporatedby reference.

BACKGROUND Technical field

The present disclosure relates generally to instruments for surgicallyjoining tissue and, more specifically, to an accessory for graspingand/or clamping tissue, for use with a surgical instrument for joiningand/or cutting tissue.

Background of Related Art

Various types of surgical instruments used to surgically join tissue areknown in the art, and are commonly used, for example, for closure oftissue or organs in transection, resection, anastomoses, for occlusionof organs in thoracic and abdominal procedures, and forelectrosurgically fusing or sealing tissue.

One example of such a surgical instrument is a surgical staplinginstrument, which may include an anvil assembly, a cartridge assemblyfor supporting an array of surgical staples, an approximation mechanismfor approximating the cartridge and anvil assemblies, and a firingmechanism for ejecting the surgical staples from the cartridge assembly.

Using a surgical stapling instrument, it is common for a surgeon toapproximate the anvil and cartridge members. Next, the surgeon can firethe instrument to emplace staples in tissue. Additionally, the surgeonmay use the same instrument or a separate instrument to cut the tissueadjacent or between the row(s) of staples.

Other examples of a surgical instrument of the present disclosureinclude electrosurgical (e.g., monopolar and bipolar) forceps.Electrosurgical forceps utilize both mechanical clamping action andelectrical energy to affect hemostasis by heating the tissue and bloodvessels to coagulate, cauterize and/or seal tissue.

In certain procedures, some surgeons wash out the inside of an organprior to cutting and stapling (or otherwise joining) the tissue. A clampmay be used to define an area to be washed out.

SUMMARY

The present disclosure relates to an attachable clamp for use with asurgical instrument. The attachable clamp comprises a body portion, afirst jaw member, a second jaw member and an actuation mechanism. Thebody portion defines a longitudinal axis and has attachment membersconfigured to attach to an elongate portion of a surgical instrument.Each of the first jaw member and second jaw member extends distally fromthe body portion. The actuation mechanism is disposed in mechanicalcooperation with at least one of the first jaw member and the second jawmember. Actuation of the actuation mechanism moves at least one of thefirst and second jaw members between an approximated position and anopen position with respect to the other jaw member.

The attachable clamp has attachment members configured to removablyattach to the body portion and to removably attach to the elongateportion of the surgical instrument, in certain embodiments.

In certain embodiments, the first jaw member and the second jaw membermay correspond to jaws of the surgical instrument in shape andorientation.

Each of the first jaw member and the second jaw member may be curvedwith respect to the longitudinal axis and include a concave and a convexside. The jaws of the surgical instrument may be curved, and they mayhave a convex side and a concave side. In certain embodiments, theconvex side of the first jaw member and the second jaw member isdisposed adjacent the jaws of the surgical instrument, and in otherembodiments, the concave side of the first jaw member and the second jawmember is disposed adjacent the jaws of the surgical instrument.

The actuation mechanism can include a first cam plate disposed inmechanical cooperation with the first jaw member and disposed inmechanical cooperation with a rod. Translation of the rod causes thefirst jaw member to move upwardly. The translation of the rod in a firstdirection causes the first jaw member to move upwardly toward the openposition. The rod is desirably biased toward a position so that thefirst jaw member tends to move toward the approximated position.

The actuation mechanism, in certain embodiments, further comprises asecond cam plate disposed in mechanical cooperation with the second jawmember and disposed in mechanical cooperation with the rod. Translationof the rod causes the second jaw member to move downwardly. Thetranslation of the rod in a first direction causes the second jaw memberto move downwardly toward the open position.

In certain embodiments, the first jaw member and second jaw member aresubstantially parallel to one another when the jaw members are in theopen and approximated positions. The first jaw member may be stationarywith respect to the body portion.

The actuation mechanism may include a knob and a slide member, whereinrotation of the knob causes the second jaw member to pivot towards thefirst jaw member. The knob can include a plurality of teeth that areconfigured to engage a plurality of teeth on the slide member.

In another aspect, the present disclosure also relates to a method ofsurgically joining tissue. The method comprises the step of providing asurgical instrument including a handle portion, an endoscopic portionand a pair of jaw members. The endoscopic portion extends distally fromthe handle portion. The pair of jaw members is disposed adjacent adistal end of the endoscopic portion. At least one of the jaw members ismovable with respect to the other between an open position and anapproximated position for engaging body tissue therebetween. The methodalso comprises the step of providing an attachable clamp configured tobe attached to the surgical instrument. The attachable clamp includes abody portion, a first jaw member, a second jaw member, and an actuationmechanism. The body portion defines a longitudinal axis. The first andsecond jaw members extend distally from the body portion. The actuationmechanism is disposed in mechanical cooperation with at least one of thefirst jaw member and the second jaw member. At least one jaw member ofthe attachable clamp is independently movable with respect to the jawmembers of the surgical instrument. The method also includes the stepsof moving at least one jaw member of the attachable clamp from an openposition towards an approximated position to engage body tissue, movingat least one of the jaw members of the surgical instrument with respectto the other from an open position towards an approximated position toengage body tissue, and actuating the jaw members of the surgicalinstrument to join tissue.

In a further aspect of the present disclosure, an attachable clamp foruse with a surgical instrument comprises:a body portion defining alongitudinal axis and having attachment members configured to attach toa surgical instrument; a first jaw member extending distally from thebody portion; and a second jaw member extending distally from the bodyportion. The attachable clamp further includes an actuation mechanismdisposed in mechanical cooperation with at least one of the first jawmember and the second jaw member, wherein actuation of the actuationmechanism moves at least one of the first and second jaw members betweenan approximated position for clamping tissue and an open position withrespect to the other jaw member. The actuation mechanism holds the jawmembers in the approximated position and has an actuator graspable by auser for releasing the actuation mechanism.

In certain embodiments, the attachable clamp has attachment members thatare configured to removably attach to the elongate portion of thesurgical instrument. The first jaw member and second jaw member of theattachable clamp desirably correspond to jaws of the surgical instrumentin shape and orientation.

The actuation mechanism may include a first cam plate disposed inmechanical cooperation with the first jaw member and disposed inmechanical cooperation with a rod, and wherein translation of the rodcauses the first jaw member to move upwardly toward the open position.The actuation mechanism desirably biases the first jaw member and thesecond jaw member toward the approximated position.

The first jaw member and the second jaw member are substantiallyparallel to one another when the jaw members are in the open andapproximated positions, in certain embodiments. The first jaw member maybe stationary with respect to the body potion.

The actuation mechanism includes a slide member having teeth, in certainembodiments of the present disclosure. The actuation mechanism mayincludes locking member that engages the teeth of the slide member. Theteeth are configured to allow the slide member to slide with respect tothe locking member in a first direction and configured to engage thelocking member to move the slide member in a second direction.

In certain embodiments, the actuation mechanism includes a detentconfigured to allow the slide member to slide with respect to the detentin a first direction and configured to engage the slide member to movethe slide member in a second direction.

BRIEF DESCRIPTION OF FIGURES

Various embodiments of the presently disclosed surgical instrument aredisclosed herein with reference to the drawings, wherein:

FIG. 1A is a perspective view of a linear surgical stapling instrumentincluding an attachable clamp in accordance with the present disclosure;

FIG. 1B is a perspective view of an surgical stapling instrument havingcurved jaw members and including an attachable clamp in accordance withthe present disclosure;

FIG. 1C is a perspective view of a vessel sealing instrument includingan attachable clamp in accordance with the present disclosure;

FIGS. 2-4 are perspective views of an accessory according to anembodiment of the present disclosure, shown at various stages ofoperation, for use with the surgical instruments of FIGS. 1A and 1B;

FIG. 5 is an exploded views of the accessory according to the embodimentshown in FIGS. 2-4, illustrating a closing mechanism for use with aclamp;

FIG. 6 is a perspective view of an accessory according to a furtherembodiment of the present disclosure, illustrating a closing mechanismfor use with a clamp;

FIG. 7 is a perspective view of the accessory of FIG. 6;

FIG. 8 is a bottom view of the accessory of FIGS. 6-7;

FIG. 9 is another perspective view of the accessory of FIGS. 5-8; and

FIG. 10 is a side view of an actuation mechanism according to anembodiment of the present disclosure.

DETAILED DESCRIPTION

Embodiments of the presently disclosed clamp for use with a surgicalinstrument are described in detail with reference to the drawings,wherein like reference numerals designate corresponding elements in eachof the several views. In the description that follows, the term“proximal” refers to the end or portion of the clamp closer to theclinician, whereas the term “distal” refers to the end or portion of theclamp farther away from the clinician.

Referring initially to FIGS. 1A-1C, various surgical instruments areshown in accordance with the present disclosure. In particular, FIG. 1Adiscloses a linear surgical stapling instrument 10 a, FIG. 1B disclosesa surgical stapling instrument 10 b having curved jaws 23 b, and FIG. 1Cdiscloses a vessel sealing instrument 10 c. As discussed herein,surgical instruments 10 a-10 c are collectively referred to as referencenumber 10.

With reference to FIG. 1A, linear surgical stapling apparatus 10 aincludes a handle assembly 12 a near a proximal end, an end effector 16a near a distal end and an elongate portion 18 a therebetween. The endeffector 16 a may be positioned within a body cavity to engage tissue ata surgical site while handle assembly 12 a is manipulatable by a surgeonfrom outside the body cavity to control the movement and operation ofthe end effector 16 a. Elongate portion 18 a defines a longitudinal axisA-A.

End effector 16 a includes a cartridge assembly, which houses aplurality of staples arranged in linear rows, and an anvil assembly forforming the staples. At least one of the cartridge assembly and theanvil assembly is movable with respect to the other between an openposition wherein the cartridge assembly is substantially spaced from theanvil assembly and an approximated position where the cartridge assemblyand the anvil assembly are closer together. A pivotable trigger 24 a ofthe handle assembly 12 a is movable through an actuation stroke orstrokes relative to a stationary grip member 28 a to move the cartridgeassembly in relation to the anvil assembly between the open position andthe approximated position and to eject the staples from the cartridgeassembly. Further details of a linear surgical stapling instrument aredescribed in detail in commonly-owned U.S. Pat. No. 6,953,139 toMilliman et al., the entire contents of which are hereby incorporated byreference herein. The cartridge assembly may include a replaceablecartridge body that houses the staples and staple pushers.Alternatively, the end effector 16 a may form part of a separate,replaceable loading unit that is attachable to the elongate portion 18 aof the stapling apparatus 10 a. The loading unit includes an elongatebody that is configured to attach to the elongate portion 18 a through adetent, bayonet or similar attachment feature. The end effector 16 a maybe pivotably attached to the elongate body, in the example of a loadingunit, or the elongate portion 18 a, in the example of a staplingapparatus where a replaceable cartridge body is used.

With reference to FIG. 1B, surgical stapling apparatus 10 b havingcurved jaws 23 b is shown. Surgical stapling apparatus 10 b and linearsurgical stapling apparatus 10 a share various common features,including handle assembly 12 b, end effector 16 b, and elongate portion18 b, as discussed above. The surgical stapling apparatus 10 b includescurved jaws 23 b. That is, surgical stapling apparatus 10 b includes anend effector 16 b having a cartridge assembly and an anvil assembly(collectively “jaws 23 b”), that are each curved with respect to alongitudinal axis B-B, defined by elongated portion 18 b. It isenvisioned that curved jaws 23 b facilitate performing certain types ofsurgical procedures. The curved jaws are arranged to facilitate use inprocedures involving limited access to the targeted surgical site. Forexample, curved jaws 23 b, as compared to linear jaws (such as the jawsillustrated in FIG. 1A), may help facilitate access to lower pelvisregions, e.g., during lower anterior resection (“LAR”). Additionally,the inclusion of curved jaws 23 b may allow increased visualization to asurgical site and may also allow more room for a surgeon to manipulatetarget tissue or the jaws 23 b themselves with his or her hand. Thecartridge assembly may include a replaceable cartridge body that housesthe staples and staple pushers. Alternatively, the end effector 16 b mayform part of a separate, replaceable loading unit that is attachable tothe elongate portion 18 b of the stapling apparatus 10 b. The loadingunit includes an elongate body that is configured to attach to theelongate portion 18 b through a detent, bayonet or similar attachmentfeature. The end effector 16 b may be pivotably attached to the elongatebody, in the example of a loading unit, or the elongate portion 18 b, inthe example of a stapling apparatus where a replaceable cartridge bodyis used.

Referring now to FIG. 1C, a vessel sealing instrument 10 c may alsoembody various aspects of the present disclosure. Vessel sealinginstrument 10 c includes a connector assembly 110 c for connection to asource of electrosurgical energy (not shown). Vessel sealing instrument10 c includes a handle assembly 12 c near a proximal end, an endeffector 16 c near a distal end and an elongate portion 18 ctherebetween. The end effector 16 c may be positioned within a bodycavity to engage tissue at a surgical site while handle assembly 12 c ismanipulatable by a surgeon from outside the body cavity to control themovement and operation of the end effector 16 c. Handle assembly 12 cincludes a movable handle 24 c, which may be manipulated to open andclose the jaws of end effector 16 c, and a trigger 25 c, which may bemanipulated to initiate an electrosurgical current. Further details of avessel sealing instrument are described in U.S. Pat. No. 7,083,618,which is incorporated herein in its entirety by reference.

An accessory for grasping and/or clamping tissue is shown in FIGS. 1A-1Cas attachable clamp 200. FIG. 1A illustrates an attachable clamp 200 aengaged with linear surgical stapling instrument 10 a. In thisembodiment, clamp 200 a includes a first linear jaw member 210 a and asecond linear jaw member 220 a. FIG. 1B illustrates an attachable clamp200 b engaged with surgical stapling instrument 10 b having curved jaws.In this embodiment, clamp 200 b includes a first curved jaw member 210 band a second curved jaw member 220 b. FIG. 1C illustrates an attachableclamp 200 c engaged with vessel sealing instrument 10 c. In thisembodiment, clamp 200 c includes a first linear jaw member 210 c and asecond linear jaw member 220 c. While FIGS. 1A-1C illustrate one type ofan attachable clamp 200, other embodiments of attachable clamps aredescribed herein (as reference numbers 300 and 400) and each embodimentthereof is configured for use with surgical instruments 10.

Referring back to FIG. 1B, the curvature of jaw members 210 b, 220 b ofattachable clamp 200 b is shown as being approximately equal to, orcorresponding to, the curvature of jaws 23 b of surgical staplinginstrument 10 b. While not explicitly shown, it is envisioned that thecurvature of jaw members 210 b, 220 b of attachable clamp 200 b iseither greater than or less than the curvature of jaws 23 b of surgicalstapling instrument 10 b. It is also envisioned that the curvature offirst jaw member 210 b is different from the curvature of second jawmember 220 b. In the surgical stapling instrument shown in FIG. 1B, jaws23 b have a concave side 290 and a convex side 291. Additionally, jawmembers 210 b, 220 b of attachable clamp 200 b are shown having aconcave side 211 and a convex side 212. However, other curved shapes canbe used for jaws 23 b and/or jaw members 210 b, 220 b.

Referring now to FIGS. 2-5, various details of an attachable clamp inaccordance with an embodiment of the present disclosure are illustrated.In this embodiment, attachable clamp is generally referred to asreference number 300. Attachable clamp 300 includes a first jaw member310 and a second jaw member 320 that extend distally from an elongatedbody portion 330. Elongated body potion 330 is shown being comprised ofa first body half 332 and a second body half 334 (first body half 332 isomitted in FIG. 4). A plurality of apertures 336 is disposed on each ofthe first body half 332 and the second body half 334 and may be used(e.g., in combination with appropriate fasteners such as screws, rivetssnap-fit connectors, ultrasonic welds, etc.) to facilitate theattachment of each body half 332, 334 to one another and to a frame 340.

With reference to the assembly view illustrated in FIG. 5, clampattachment 300 also includes an actuation mechanism 335 including aframe 240, a first cam plate 350, a second cam plate 360, a lower arm370, an upper arm 380, and a rod 390. The lower arm 370 has the firstjaw member 310, which may be attached thereto or formed integrallyformed therewith. The first jaw member 310 desirably includes a tissuecontact surface 310 a. The upper arm 380 has the second jaw member 320,which may be attached thereto or formed integrally formed therewith. Thesecond jaw member includes a tissue contact surface 320 a. Frame 340 isdisposed between and is relatively stationary with respect to first bodyhalf 332 and second body half 334, and includes vertically disposedslots 342 (two slots are shown) extending therethrough. At least aportion of slots 342 is configured for substantial alignment with atleast a portion of corresponding diagonally disposed slots 352 in thefirst cam plate 350 and diagonally disposed slots 362 in the second camplate 360. Additionally, at least a portion of slots 342 is configuredto substantially align with corresponding apertures 372, 382 inrespective lower arm 370 and upper arm 380. As discussed in more detailbelow, a plurality of pins 395 is used to movably secure first cam plate350 with respect to frame 340 and lower arm 370 via slots 352, 342, andapertures 372, respectively. Additionally, a plurality of pins 395(either the same pins or an additional set of pins) is used to movablysecure second cam plate 360 with respect to frame 340 and upper arm 380via slots 362, 342 and apertures 382, respectively.

The first cam plate 350 includes an aperture 354 disposed adjacent aproximal portion thereof and the second cam plate 360 includes anaperture 364 disposed adjacent a proximal portion thereof. Additionally,the rod 390 includes a pair of apertures 392 disposed adjacent a distalportion thereof. A pin 394 extends through apertures 354, 392 and 364 tosecure rod 390 to cam plates 350, 360.

With continued reference to FIG. 5, the frame 340 includes a spring plug344 disposed in mechanical cooperation therewith. Spring plug 344 isconfigured to engage a distal portion of a biasing member 346 (e.g., ahelical spring). A proximal portion of biasing member 346 is configuredto engage the distal portion of rod 390. Accordingly, the biasing member346 is configured to bias rod 390 proximally with respect to frame 340.

In use, to operate attachable clamp 300, a user distally pushes a knob396 of rod 390 against the bias of biasing member 346 to move the jawmembers 310 and 320 towards the open position. More particularly, sincethe rod 390 is pinned to first cam plate 350 and second cam plate 360,distal movement of the rod 390 causes distal translation of cam plates350 and 360. With initial regard to the first jaw member 310, as thefirst cam plate 350 translates distally, the pinned relationship betweenthe lower arm 370, the slots 352 (which slope upward as they extenddistally), and the vertical slots 342, causes the lower arm 370 to movedownward with respect to frame 340. That is, when the first cam plate350 is moved distally, the pins 395 travel downwardly and proximallywith respect to slots 352. Moreover, the vertical slots 342 limit themotion of the lower arm 370 such that the lower arm 370 only movesdownwardly (and not proximally) with respect to frame 340.

Correspondingly, with regard to the second jaw member 320, as the secondcam plate 360 translates distally, the pinned relationship between theupper arm 380, the slots 362 (which slope downward as they extenddistally), and the vertical slots 342, causes the upper arm 380 to moveupward with respect to frame 340. That is, when the second cam plate 360is moved distally, the pins 395 travel upwardly and proximally withrespect to slots 362. Moreover, the vertical slots 342 limit the motionof the upper arm 380 such that the upper arm 380 only moves upwardly(and not proximally) with respect to frame 340.

As can be appreciated with reference to FIGS. 2-5 and with reference tothe discussion hereinabove, proximal movement of the knob 396 (i.e., inthe direction provided by the bias of biasing member 346) causes firstcam plate 350 and second cam plate 360 to move proximally. Proximalmovement of first cam plate 350 causes lower arm 370 to move upward withrespect to frame 340. Proximal movement of second cam plate 360 causesupper arm 380 to move downward with respect to frame 340. Thus, the jawmembers 310, 320 move between a first substantially parallelapproximated position (FIG. 2) and a second substantially parallel openposition (FIG. 3). Additionally, as described above, the jaw members310, 320 of attachable clamp 300 are biased towards their approximatedpositions. As can be appreciated, a particular biasing member 346 may beselected (e.g., having a particular spring constant) to provide adesired about of closing force.

It is also envisioned that attachable clamp 300 includes structure toreleasably lock jaw members 310, 320 in an open position. In such anembodiment, a proximal portion 390 a of rod 390 is translatable withrespect to a distal portion 390 b thereof. Additionally, proximalportion 390 a is proximally biased with respect to distal portion 390 bvia biasing member 390 c (e.g., helical spring). See FIG. 5. Proximalportion 390 a includes a pin 391 that is configured to ride along asubstantially “L”-shaped slot 391 a disposed in first body half 332 (asillustrated in FIG. 5) or second body half 334. Once pin 391 is fullytranslated distally with respect to slot 391 a (i.e., pin 391 movesalong a first leg of slot 391 a), proximal portion 390 a can be rotatedabout longitudinal axis “A-A” such that pin 391 moves along a second legof slot 391 a, thus preventing proximal translation of proximal portion390 a with respect to distal portion 390 b, which releasably locks jawmembers 310, 320 in the open position.

While not explicitly illustrated, it is envisioned that one of the firstjaw member 310 and the second jaw member 320 is stationary with respectto frame 340. In such an embodiment, lower arm 370 or upper arm 380would be stationary with respect to frame 340. That is, first cam plate350 or second cam plate 360 could be omitted from the design or could beconfigured to not include slots 352 or 362. Further, the orientation ofslots 352 or 362 could be configured to limit or otherwise adjust therelative movement between either first cam plate 350 and lower arm 370,or second cam plate 360 and upper arm 380. Additionally, while lower arm370 and upper arm 380 are illustrated as being curved with respect tothe longitudinal axis “A-A,” it is envisioned that lower arm 370 andupper arm 380 are co-linear with respect to the longitudinal axis “A-A,”e.g., for use with a surgical instrument having linear jaw member (e.g.,linear surgical stapling instrument 10 a of FIG. 1A or vessel sealinginstrument 10 c of FIG. 1C).

It is contemplated that the curvature of the first jaw member and secondjaw member of the attachable clamp 300 can be adjusted so that theattachable clamp is disposed on the concave side 290 of the jaws 23 b orthe convex side 291 of the jaws 23 b of the surgical apparatus 10 b (seeFIG. 1B).

With reference to FIGS. 6-9, another embodiment of an accessory forgrasping and/or clamping tissue is shown and is depicted as attachableclamp 400. Attachable clamp 400 includes a first jaw member 410, asecond jaw member 420, and an actuation mechanism 425 including a bodyportion 430, a slide member 440, and a knob 450. In this embodiment,first jaw member 410 and body portion 430 are stationary with respect toeach other (and with respect to elongate portion 18 of surgicalinstrument 10 when attached thereto) and may be monolithically formedwith each other. Second jaw member 420 is pivotably disposed withrespect to first jaw member 410 and body portion 430 via pivot pin 460(FIGS. 6 and 7). Pivot pin 460 also extends through a pivot tab 470, asdiscussed in more detail below. The first jaw member 410 has a tissuecontact surface 410 a that faces a tissue contact surface 420 a on thesecond jaw member 420.

Pivot tab 470 is disposed adjacent a distal portion of slide member 440and adjacent a proximal portion of second jaw member 420 (FIGS. 6 and7). Additionally, pivot tab 470 is fixed to second jaw member 420. It isenvisioned that pivot tab 470 is biased via a biasing member 472 (e.g.,helical spring) such that second jaw member 420 is urged towards itsopen position (FIG. 7).

Slide member 440 includes slots 442 therein to accommodate pins 432 ofthe body portion 430 (see FIG. 9), such that slide member 440 islongitudinally translatable with respect to body portion 430. Withparticular reference to FIG. 9, a proximal portion of slide member 440includes a plurality of teeth 444 thereon, which are configured toengage a plurality of teeth 452 of knob 450.

In use, to operate attachable clamp 400, a user rotates knob 450 topivotably move second jaw member 420 between its open (FIG. 7) andapproximated (FIG. 6) positions. More particularly and with specificreference to FIG. 9, rotation of knob 450 in the direction of arrow “A”causes second jaw member 420 to move towards its approximated position.Rotation of knob 450 in the direction of arrow “B” causes second jawmember 420 to move towards its open position. Specifically, uponrotation of knob 450 in the direction of arrow “A,” the interactionbetween teeth 452 of knob 450 and teeth 444 of slide member 440 causesslide member 440 to distally translate such that a distal face 446 (FIG.6) of slide member 440 engages an approximation surface 422 (FIG. 7) ofsecond jaw member 420, thus causing second jaw member 420 to pivottowards first jaw member 410 against the bias of biasing member 472.Correspondingly, upon rotation of knob 450 in the direction of arrow“B,” the interaction between teeth 452 of knob 450 and teeth 444 ofslide member 440 causes slide member 440 to proximally translate, thuscausing second jaw member 420 to pivot away from first jaw member 410.That is, distal face 446 of slide member 440 moves proximally pastapproximation surface 422 of second jaw member 420, thus allowingbiasing member 472 to return second jaw member 420 to its open position.

With reference to FIG. 10, another embodiment of an actuation mechanismfor use with an accessory of the present disclosure is shown and isdepicted as reference number 480. Actuation mechanism 480 includes a camlever 482 that is pivotably engaged with a body portion 484 of theattachable clamp about pivot pin 486, and pivotably engaged with a slidemember 488 of the attachable clamp about pivot pin 490. It is envisionedthat body portion 484 is mechanically engaged with a first jaw member ofan attachable clamp and that slide member 488 is mechanically engagedwith a second jaw member of an attachable clamp.

With continued reference to FIG. 10, actuation mechanism also includes aratchet mechanism 492. Ratchet mechanism 492 includes a plurality ofteeth 494 disposed on body portion 484 and a plurality of teeth 496disposed on slide member 488, and is configured to allow controlled andstepped distal advancement of slide member 488 with respect to bodyportion 484. More particularly, teeth 494 include angled walls 494 a andflats or locking member 494 b, and teeth 496 include angled walls 496 aand flats 496 b. As can be appreciated, the interaction between angledwalls 494 a, 496 a and flats 494 b, 496 b allow movement in the distaldirection, but prevent movement in the proximal direction. That is, theflats 494 b, 496 b maintain slide member 488 in a desired longitudinalposition, while restricting the proximal force applied by the compressedtissue.

In use, as cam lever 482 is pushed in the direction of arrow “C,” camlever 482 rotates about pivot pin 486. Pin 490 connects cam lever 482 toslide member 488 such that rotation of cam lever 482 in the direction ofarrow “C” distally translates slide member 488 to clamp tissue, forexample. Additionally, movement of cam lever 482 in the direction ofarrow “D” causes slide member 488 to move proximally with respect tobody portion 484, which causes the second jaw member to move towards itsopen position. Moreover, movement of cam lever 482 in the direction ofarrow “D” causes slide member 488 to lift upwardly, thus disengagingteeth 494, 496 and enabling proximal translation of slide member 488with respect to body portion 484.

In each of the illustrated embodiments, each attachable clamp 200, 300,400 is configured to removably engage surgical instrument 10. Moreparticularly, attachable clamp 200 may include one or more attachmentmembers, such as a series of tabs 500, which are configured to clip orslide onto the elongate portion 118 of (and/or a portion of a loadingunit configured for use with) the surgical instrument 10. Additionally,it is envisioned that the tabs 500 are removable and/or able to bereoriented (e.g. via screws or the like) to place the tabs 500 on theopposite lateral side of the attachable clamp 200, 300, 400, forexample. It is also envisioned that each attachable clamp 200, 300, 400is attachable to the surgical instrument 10 via other suitable means,such as, for example, screws.

When attachable clamp 200, 300, 400 is used in combination with surgicalinstrument 10 to compress tissue, it is envisioned that a user mayposition jaw members 210 and 220, 310, 320, or 410 and 420 of attachableclamp 200, 300, or 400, respectively, about tissue adjacent the locationwhere the tissue will be joined. After the tissue is clamped, and priorto the joining of tissue, the clinician may perform a washout. It isalso envisioned that when the jaw members of the attachable clamp are inthe approximated position, the user can manipulate (e.g., slightly move)the jaws 23 of the surgical instrument 10.

The present disclosure also relates to a method of using attachableclamp 200, 300, 400 during a surgical procedure. The method includesproviding a surgical instrument 10; attaching an attachable clamp to thesurgical instrument, the attachable clamp being configured forattachment to the surgical instrument 10; positioning the jaw members ofthe surgical instrument 10 adjacent tissue; moving at least one jawmember of the attachable clamp from an open position towards anapproximated position to engage body tissue; moving at least one of thejaw members of the surgical instrument with respect to the other from anopen position towards an approximated position to engage body tissue;and actuating the jaw members of the surgical instrument to join tissue.The method may also include the step of cleansing tissue (e.g.,performing a washout) between the steps of moving at least one of thejaw members of the surgical instrument with respect to the other from anopen position towards an approximated position to engage body tissue andactuating the jaw members of the surgical instrument to join tissue. Forexample, in the resection of colonic tissue, the rectum may be washedout while the clamp jaw members are clamped onto the tissue. Then, thesurgical stapling instrument (or other instrument for joining tissue) isapplied to the section of tissue that has been washed out.

While the above description contains many specifics, these specificsshould not be construed as limitations on the scope of the presentdisclosure, but merely as illustrations of various embodiments thereof.Therefore, the above description should not be construed as limiting,but merely as exemplifications of various embodiments. Those skilled inthe art will envision other modifications within the scope and spirit ofthe disclosure.

1. A method of performing surgery on a hollow organ, comprising:providing a surgical stapling instrument having curved jaws with aninner side and an outer side; and attaching a clamp to the surgicalstapling instrument.